Yoshiyuki Ichihashi

Keio University, Edo, Tokyo, Japan

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Publications (10)15.43 Total impact

  • T. Ide · Y. Ichihashi · I. Toda · T. Fukumoto · K. Tsubota
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    ABSTRACT: We report the case of a 32-year-old male patient who presented with conjunctival redness after multiple bilateral eye-whitening surgeries. Slit-lamp examination revealed scleral melting, avascular areas, and demarcation lines in both eyes. Considering the treatment history and the clinical findings of the patient, we conclude that the removal of the conjunctiva and Tenon’s layer and use of mitomycin C is not desirable for a healthy ocular surface.
    No preview · Article · Aug 2015 · Asian Journal of Ophthalmology
  • Yoshiyuki Ichihashi · Takeshi Ide · Minako Kaido · Reiko Ishida · Shin Hatou · Kazuo Tsubota
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    ABSTRACT: To describe a case series in which corneal fluorescein staining (CFS) development occurred in short break-up time (s-BUT) dry eyes after a short period during prolonged opening of the eye.
    No preview · Article · May 2015 · Taiwan Journal of Ophthalmology
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    ABSTRACT: To evaluate the validity of a dry eye (DE) screening method in visual display terminal (VDT) workers using functional visual acuity (VA) measurement combined with a symptoms questionnaire, and to make recommendations regarding practical use of the screening. This prospective cross-sectional study included 369 young and middle-age office workers, who use VDTs. Subjects completed two types of DE questionnaires and underwent DE testing and functional VA measurement. Subjects were assigned to DE and non-DE groups. Sensitivity and specificity of the DE prediction value were assessed. According to the probability distribution of DE and non-DE calculated by the discriminant analysis formula, we classified subjects into three categories based on the most appropriate cut-off levels. Positive predictive value (PPV) and negative predictive value (NPV) of the DE prediction value were also assessed. Of 369 subjects, 218 and 151 subjects were assigned to the DE and non-DE groups, respectively. Sensitivity and specificity were 93.1% and 43.7%, respectively. Based on the probability prediction, the cut-off levels were defined as probability prediction ≥85%, 45%≤ probability prediction <85% and probability prediction <45%. Subjects with a probability prediction ≥85% were defined positive (N=130), while those with values <45% were defined as negative (N=73). The PPV and NPV were 83.8% and 80.8%, respectively. Acceptable PPV and NPV were obtained by setting three discriminate categories. This improved version of the DE screening method may be acceptable for practical use in VDT workers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
    No preview · Article · Apr 2015 · The British journal of ophthalmology
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    ABSTRACT: IgG4-related Mikulicz's disease (MD) is a fibrosis-associated inflammatory disease, often accompanied by lacrimal gland swelling. Although much attention has been paid to the inflammatory aspects of this disease, the mechanisms of the fibrotic processes are still unclear. We focused on the fibrotic changes occurring in the lacrimal glands of IgG4-related MD patients, by examining molecules involved in the epithelial-mesenchymal transition (EMT). Lacrimal gland tissue specimens were obtained from 3 IgG4-related MD patients and 3 control patients with Sjögren's syndrome (SS). The glands were examined by immunohistochemistry and transmission electron microscopy. Storiform fibrosis, a characteristic of IgG4-related MD, was observed in the IgG4-related MD, but rarely in the SS lacrimal glands. Reduced E-cadherin expression, increased phalloidin-stained filamentous actin, and increased α-smooth muscle actin, snail, and heat-shock protein 47 were observed in the IgG4-related MD compared with the SS lacrimal glands. Transmission electron microscopy revealed an abnormal periodicity of collagen bundles, and basal membrane thickening in the IgG4-related MD compared with the SS tissues. EMT-like changes were frequently observed in the lacrimal gland epithelia from patients with IgG4-related MD. Thus, EMT may be involved in the pathology of IgG4-related MD fibrosis.
    No preview · Article · Mar 2015 · Modern Rheumatology
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    ABSTRACT: Purpose: The aim of this study was to estimate the prevalence of dry eye disease (DED) in Japanese visual display terminal (VDT) workers and identify simple methods for screening DED during occupational health examinations. Methods: This study involved 369 (331 men and 38 women; mean age, 44.4 [8.8] years) workers engaged in PC development with approximately 6 hours of VDT use daily. The participants completed questionnaires on dry eye and physical symptoms affecting QoL, and their ability to keep their eyes open for 10 seconds was tested for DED screening. They also underwent assessment of conjunctival and corneal vital staining with lissamine green and fluorescein, measurement of tear film breakup time, and Schirmer's test for DED diagnosis. Sensitivity, specificity, and positive predictive value of the screening methods were assessed. Results: The DED group included 218 (definite, 14; probable, 204) participants. They had markedly high frequencies of 11 dry eye symptoms, especially ocular fatigue (OR, 17.1; 95% CI, 9.9 to 29.7) and dry sensation (OR, 8.2; 95% CI, 3.6 to 18.4), and were more often unable to keep their eyes open for 10 s. With either ocular fatigue or dry sensation as the cutoff criterion, the sensitivity, specificity, and positive predictive value were 89.9, 66.9, and 79.7%, respectively. Conclusions: Approximately 60% of the VDT workers were diagnosed with DED on the basis of diverse eye symptoms affecting their ability to work. The dry eye symptom questionnaire and 10-s eye-opening test are simple, noninvasive, and inexpensive methods for screening DED during occupational health examinations.(J Occup Health 2015; 57: 253-258).
    Full-text · Article · Mar 2015 · Journal of Occupational Health
  • Ikuko Toda · Takeshi Ide · Teruki Fukumoto · Yoshiyuki Ichihashi · Kazuo Tsubota
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    ABSTRACT: To evaluate the possible advantages of combination therapy with diquafosol tetrasodium and sodium hyaluronate for dry eye after laser in situ keratomileusis (LASIK). Prospective randomized comparative trial. A total of 206 eyes of 105 patients who underwent LASIK were enrolled in this study. Patients were randomly assigned to 1 of 4 treatment groups according to the postoperative treatment: artificial tears, sodium hyaluronate, diquafosol tetrasodium, and a combination of hyaluronate and diquafosol. Questionnaire responses reflecting subjective dry eye symptoms, uncorrected and corrected visual acuity, functional visual acuity, manifest refraction, tear break-up time, fluorescein corneal staining, Schirmer test, and corneal sensitivity were examined before and 1 week and 1 month after LASIK. Distance uncorrected visual acuity was significantly better in the combination group than in the hyaluronate group 1 week and 1 month after LASIK. Near uncorrected visual acuity was significantly better in the combination group than in the artificial tear and diquafosol groups 1 week and 1 month after LASIK. Distance functional visual acuity improved significantly only in the combination group 1 month after LASIK. The Schirmer value in the combination group was significantly higher than that in the hyaluronate group at 1 month after LASIK. Subjective dry eye symptoms in the combination group improved significantly compared with those in the other groups 1 week after surgery. Our results suggest that hyaluronate and diquafosol combination therapy is beneficial for early stabilization of visual performance and improvement of subjective dry eye symptoms in patients after LASIK.
    No preview · Article · Mar 2014 · American Journal of Ophthalmology
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    ABSTRACT: Purpose: To report and compare the long-term outcome of penetrating and deep anterior lamellar keratoplasty. Cases and Method: This retrospective study was made on 36 cases who received keratoplasty by a single surgeon during past 10 years. The series comprised 27 males and 9 females. There were 25 eyes of keratoconus, 7 eyes of corneal leukoma, and 3 eyes of corneal degeneration. Deep anterior lamellar keratoplasty was performed on 21 cases and penetrating keratoplasty on 21 eyes. Cases were followed up for 2 to 10 years, average 5 years. Results: Final visual acuity averaged 0.72 after lamellar and 0.85 after penetrating keratoplasty. There was no significant difference. Spherical equivalent of refraction showed a tendency to myopia with no difference between the two groups. Corneal endothelial cell density decreased by 11.0±6.6% immediately after lamellar and 59.5±29.0% after penetrating keratoplasty (p< 0.01). Conclusion: There was no difference in visual function and safety between deep anterior lamellar keratoplasty and penetrating keratoplasty for 2 years or longer.
    No preview · Article · Jan 2013
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    ABSTRACT: Purpose: We evaluated the levels of lipid oxidative stress markers and inflammatory cells from tears and conjunctiva of patients with Sjögren syndrome (SS) and normal subjects. Methods: We examined 31 eyes of 16 patients (16 females) with SS and 15 eyes of 10 healthy controls (2 males and 8 females) in this prospective study. All subjects underwent a Schirmer test, measurement of tear film break-up time, vital stainings, confocal microscopy of the conjunctiva, tear collection for hexanoyl-lysine (HEL), ELISA, and conjunctival brush cytology. Brush cytology samples underwent immunohistochemistry (IHC) staining with HEL and 4-hydroxy-2-nonenal (4HNE). Hematoxylin-eosin and IHC staining with HEL and 4HNE also were performed on conjunctival samples of SS patients and controls. Results: The tear stability and vital staining scores were significantly worse in eyes of SS patients compared to the controls. Conjunctival inflammatory cell density was significantly higher in SS subjects compared to controls. The numbers of conjunctival cells stained positively for HEL and 4HNE were significantly higher in SS patients compared to controls. Tear HEL concentrations correlated significantly with staining scores and inflammatory cell density in confocal microscopy. Conjunctival specimens also revealed higher numbers of cells stained positively for inflammatory markers, as well as HEL and 4HNE in the IHC stainings. Conclusions: Increase of the oxidative stress status in the conjunctiva of SS patients appears to have a role in the pathogenesis of dry eye disease. A close relationship may exist between reactive oxygen species (ROS) production, lipid peroxidation related membrane damage, and inflammatory processes in dry eye.
    No preview · Article · Nov 2012 · Investigative ophthalmology & visual science
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    ABSTRACT: Purpose: To compare the safety of domestic and overseas donor corneas for keratoplasty. Objects and Method: This study was made on 490 eyes donated to us through eyebanks in the past 5 years through 2010. The series comprised 245 eyes from domestic donors and 245 eyes from USA. Results: Age of domestic donors averaged 68.8 years and that of overseas donors averaged 63.1 years. The difference was significant (p<0.01). Corneal endothelial density averaged 2713.3 and 2515.3/mm 2 respectively. The difference was significant (p<0.01). Primary graft failure occurred in 4 domestic eyes and none in overseas eyes. There was no difference in the positive rate of culture from corneal limbus or preservation medium between domestic and overseas donor eyes. Conclusion: The mean corneal endothelial density was higher in domestic than in overseas cornea. Primary graft failure was more frequent in domestic than overseas eyes. More strict quality control is desired for donated corneas.
    No preview · Article · Sep 2012
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    ABSTRACT: To report the efficacy of simultaneous keratolimbal allograft (KLAL) surgery and deep anterior lamellar keratoplasty (DALK) for limbal stem cell deficiency (LSCD). We conducted a retrospective, interventional case series of six consecutive eyes of five patients with LSCD and stromal opacity due to gelatinous drop-like dystrophy (two eyes), Stevens-Johnson syndrome (SJS, two eyes), or aniridia (two eyes). Only patients with normal lid anatomy and Schirmer test values greater than 3 mm were enrolled. DALK was performed by viscodissection followed by a thin, 360° KLAL designed by using an artificial anterior chamber. KLAL sutures were removed after 2 weeks. DALK and KLAL were successfully performed in all eyes, which were followed for an average of 17.2 ± 10.8 months. All eyes recovered a smooth corneal epithelium, although one SJS patient developed a persistent epithelial defect (PED) leading to opacification of the central cornea. Visual acuity improved by more than 2 lines in all eyes except that of the SJS patient with PED. No other complications were observed. Simultaneous DALK and thin-section KLAL is an effective treatment for ocular surface disease in patients with residual tear function and normal lid anatomy.
    No preview · Article · Nov 2010 · Japanese Journal of Ophthalmology